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Decade-long trends (1999-2009) in the characteristics, management, and hospital outcomes of patients hospitalized with acute myocardial infarction with prior diabetes and chronic kidney disease
Open Access Articles
  • Mayra Tisminetzky, University of Massachusetts Medical School
  • David D. McManus, University of Massachusetts Medical School
  • Alon Dor, University of Massachusetts Medical School
  • Ruben Miozzo, Worcester Recovery Center and Hospital
  • Jorge L. Yarzebski, University of Massachusetts Medical School
  • Joel M. Gore, University of Massachusetts Medical School
  • Robert J. Goldberg, University of Massachusetts Medical School
UMMS Affiliation
Department of Quantitative Health Sciences; Department of Medicine, Division of Cardiovascular Medicine; Department of Psychiatry
Date
5-5-2015
Document Type
Article
Abstract

BACKGROUND: Despite the increasing magnitude and impact, there are limited data available on the clinical management and in-hospital outcomes of patients who have diabetes mellitus (DM) and chronic kidney disease (CKD) at the time of hospitalization for acute myocardial infarction (AMI). The objectives of our population-based observational study in residents of central Massachusetts were to describe decade-long trends (1999-2009) in the characteristics, in-hospital management, and hospital outcomes of AMI patients with and without these comorbidities.

METHODS: We reviewed the medical records of 6,018 persons who were hospitalized for AMI on a biennial basis between 1999 and 2009 at all eleven medical centers in central Massachusetts. Our sample consisted of the following four groups: DM with CKD (n=587), CKD without DM (n=524), DM without CKD (n=1,442), and non-DM/non-CKD (n=3,465).

RESULTS: Diabetic patients with CKD were more likely to have a higher prevalence of previously diagnosed comorbidities, to have developed heart failure acutely, and to have a longer hospital stay compared with non-DM/non-CKD patients. Between 1999 and 2009, there were marked increases in the prescribing of beta-blockers, statins, and aspirin for patients with CKD and DM as compared to those without these comorbidities. In-hospital death rates remained unchanged in patients with DM and CKD, while they declined markedly in patients with CKD without DM (20.2% dying in 1999; 11.3% dying in 2009).

CONCLUSION: Despite increases in the prescribing of effective cardiac medications, AMI patients with DM and CKD continue to experience high in-hospital death rates.

Rights and Permissions
Citation: Int J Nephrol Renovasc Dis. 2015 May 5;8:41-51. doi: 10.2147/IJNRD.S78749. eCollection 2015. Link to article on publisher's site
Comments
Copyright © 2015 Tisminetzky et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
Related Resources
Link to Article in PubMed
Keywords
  • chronic kidney disease,
  • diabetes,
  • myocardial infarction
PubMed ID
25999755
Creative Commons License
Creative Commons Attribution-Noncommercial 3.0
Citation Information
Mayra Tisminetzky, David D. McManus, Alon Dor, Ruben Miozzo, et al.. "Decade-long trends (1999-2009) in the characteristics, management, and hospital outcomes of patients hospitalized with acute myocardial infarction with prior diabetes and chronic kidney disease" Vol. 8 (2015) ISSN: 1178-7058 (Linking)
Available at: http://works.bepress.com/jorge_yarzebski/103/